Gavel and stethoscope.

Eight Opportunities to Use the Law to Address Social Determinants of Health

By Jon Larsen and Sterling Johnson

Addressing the opioid crisis cannot stop at providing better access to treatment for opioid use disorder (OUD), expanding and enhancing harm reduction efforts, and reimagining the role of law enforcement, as explored previously in this blog series. The response must go further to make treatment and harm reduction more effective, by acknowledging the opioid epidemic as a reflection of the conditions of the whole society, identifying those conditions, and addressing them head-on. A whole-person response to OUD and other substance use disorders needs a well-coordinated whole-of-government response to address myriad societal issues that are critical to effective drug treatment, including, but not limited to, housing, education, economic development, and tax policy.   

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Disposable syringe isolated on black background.

Six Opportunities to Use the Law to Support Harm Reduction

By Jon Larsen and Sterling Johnson

Harm reduction in the context of the opioid crisis is focused on preventing overdose and infectious disease transmission by working with people who use drugs without moral judgment. Far too often, the public health imperative of harm reduction is blocked by federal policy, state laws, and other structural barriers anchored in the “war on drugs” that reduce the effectiveness of harm reduction efforts. To maximize the potential of harm reduction requires a whole-of-government approach, involving coordination across levels of government. 

As noted in this recent report, “Bringing the W-G approach to bear on a complex problem depends on several components, including agreement as to the problem, understanding the problem, and the causes of the problem. For many involved in government at all levels, the harm reduction challenge unfortunately falls at the first of those hurdles.”

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Judge's gavel, handcuffs and scales on grey background, flat lay with space for text. Criminal law concept.

Seven Opportunities to Use the Law to Address Drug Policing

By Jon Larsen and Sterling Johnson

There is a well-established whole of government response to drug policing centered around the “war on drugs.” However, the existing response is largely built on flawed policies that have resulted in mass incarceration, structural racism, and lagging improvements in treatment and harm reduction related to the opioid crisis. Policy changes must be considered to replace acknowledged failures and reimagine the whole of government response to drug policing. 

With support from the Foundation for Opioid Response Efforts (FORE), public health law experts from Indiana University McKinney School of Law and the Temple University Center for Public Health Law Research at the Beasley School of Law recently embarked on a systematic review of US drug policy using a whole-of-government (W-G) approach to assess where these misalignments are occurring among different agencies at the same level of government (referred to as horizontal W-G), and across different levels of government (referred to as vertical W-G). It ultimately provides a tool to address these misalignments directly. 

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Suboxone.

Five Opportunities to Use the Law to Address Persistent OUD Treatment Gaps 

By Jon Larsen and Sterling Johnson

People who need opioid use (OUD) treatment in the United States are often not receiving it — at least two million people with OUD are experiencing a treatment gap that prevents or hampers their ability to receive life-saving care and support. This reality reflects structural, policy, and legal misalignments common to the entire U.S. health care system, but that are especially present for behavioral health needs like substance use, and are exacerbated by other challenges related to stigma, lack of employment, and fragmented or nonexistent care coordination.  

With support from the Foundation for Opioid Response Efforts (FORE), public health law experts from Indiana University McKinney School of Law and the Temple University Center for Public Health Law Research at the Beasley School of Law recently embarked on a systematic review of U.S. drug policy using a whole-of-government (W-G) approach to assess where these misalignments are occurring among different agencies at the same level of government (referred to as horizontal W-G), and across different levels of government (referred to as vertical W-G). It ultimately provides a tool to address these misalignments directly. 

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empty desk.

Author Q&A: Hilary Wething on US Paid Sick Leave Policy Impacts

By Temple University Center for Public Health Law Research

Hilary Wething, PhD, is an assistant professor of public policy and a Jackman-McCourtney Early Career Professor at Penn State University. Her research examines the relationship between economic volatility and labor market policy, household decision-making, and social safety-net programs.

Dr. Wething’s research published in the Journal of Public Health Policy investigates the impact of the generosity, inclusion, and autonomy of state paid sick leave laws on influenza-like-illness (ILI) rates and its components using data from the Centers for Disease Control and CPHLR’s data on state-level paid sick leave statues.

We asked Dr. Wething a few questions about this work.

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Woman with face mask getting vaccinated.

The Right Tool for the Job: Supporting Vaccination Rates with Universal Paid Sick Leave

By Alina Schnake-Mahl, Rebecca Finkel, and Jennifer Kolker

Policies like paid sick leave are key tools to prevent another “winter of death” and disruption, finds our recent study of U.S. cities’ sick leave and vaccination data. Further, universal paid sick leave policies are particularly effective at protecting the most vulnerable communities.

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Suboxone.

Prior Authorization Insurance Requirements: A Barrier to Accessing Lifesaving Treatment for Opioid Use Disorder?

By Juan M. Hincapie-Castillo and Amie J. Goodin

Policies to mitigate the drug overdose crisis continue to fall short, as evidenced by increasing rates of opioid-involved overdoses and deaths in the United States. The COVID-19 pandemic has exacerbated this overdose crisis, and efforts are urgently needed to mitigate harm.

Individuals who have problematic opioid use are most frequently involved in opioid-involved overdoses, meaning that the use of a prescription opioid, or much more commonly a non-prescription opioid (such as non-medically sourced fentanyl or heroin), is used in a way that adversely affects the person’s life. Problematic opioid use may lead to a diagnosis of opioid use disorder (OUD). The medication buprenorphine has been proven to reduce opioid-involved overdose and harms and is one of few OUD treatments available as a prescription that can be dispensed by community pharmacies rather than from specialized facilities or specialty providers.

The federal government and several states have implemented strategies to improve and promote OUD treatment access, especially for the relatively inexpensive and effective medication buprenorphine. However, there are significant barriers that remain that preclude adequate and timely access to buprenorphine.

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Emergency department entrance.

New Legal Mapping Method Highlights Recent Laws Limiting Public Health Emergency Orders

By Katie Moran-McCabe

Throughout the COVID-19 pandemic, legislators in almost every state have introduced bills that would limit state executive authority to respond to the current pandemic or future public health emergencies. Between January 1, 2021, and November 5, 2021, one or more of these bills were enacted into law and became effective in 19 states.

This finding is a product of a new legal mapping method called Sentinel Surveillance of Emerging Laws and Policies (SSELP), developed by researchers from our Center for Public Health Law Research at Temple University (CPHLR), with support from the Robert Wood Johnson Foundation.

This mapping method is intended to quickly capture and track emerging laws and legal innovations impacting public health, and to instigate faster evaluation of their effects on health and health equity.

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Doctor in white coat neck down

Buzzwords in Patient Safety: Some Preliminary Thoughts

By John Tingle and Amanda Cattini

Every profession, service, or industry maintains what can be termed, “buzzwords.” A “buzzword” can be defined as transient, flavor-of-the-month-type word, which describes a concept than can be seen to direct policy and practice until it becomes less topical and eventually fades away from general use. These terms come and go and are often refined and come back into use. In the National Health Service (NHS) in England, we have seen such pervading terms as clinical governance, patient empowerment, controls assurance, and patient advocacy.

Today there is what can arguably be called a new buzzword, “decolonization.” This word seems very much to be the term of the day. It pervades vast areas of academic and professional life and discourse. In terms of health law and patient safety research, the decolonization of national and global patient safety systems and structures seems an interesting perspective to further peruse.

One benefit of adopting decolonization perspectives to patient safety is that we can utilize the concept as a disrupter of established thinking and seek to establish new foundations of knowledge.

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Person smoking cigarette.

Graphic Warnings on Cigarettes: Public Health vs. Corporate Speech

By Laura Karas

The latest attempt of the U.S. Food and Drug Administration (FDA) to make a dent in the country’s intractable tobacco problem is a set of color graphic warnings that will appear on cigarette packages and advertisements beginning in June of 2021.

The legal battle surrounding the graphic warnings and other attempts to regulate commercial speech in the food and drug context illustrate the courts’ enduring failure to appreciate the full extent and substantiality of the government’s interest in promoting public health.

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